chapter 22 psychotherapeutic drugs: pharm exam 2

The nurse is teaching parents of a pediatric client diagnosed with ADHD. Teaching has been about the disorder and its treatment. The nurse determines that teaching has been effective when the parents state which?

"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."

A parenteral form of an antipsychotic is prescribed for a client who has become aggressive. When administering the drug, which site would be most appropriate for the nurse to use?

Gluteus Explanation: When giving an antipsychotic parenterally, the drug should be given IM in a large muscle mass such as the gluteus muscle. The deltoid muscle is not a large muscle. The vastuslateralis and the ventrogluteal are not large muscles when a client is aggressive, the larger the muscle the better, thus gluteus is the best choice.

A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action?

Inform the prescriber and monitor for GI and CNS effects Explanation: Therapeutic serum lithium levels range from 0.6 to 1.2 mEq/L. A level of 1.8 mEq/L would be considered toxic, but would be unlikely to warrant admission to intensive care. The nurse should report the finding and assess for common adverse effects of toxicity, which include GI and CNS effects more often than respiratory effects.

A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason?

It reduces the likelihood of drug dependence or diversion.

The nurse on the unit has several clients taking clozapine. For which client is clozapine, an antipsychotic, contraindicated?

The 45-year-old with bone marrow depression Explanation: Contraindications to antipsychotic drugs include bone marrow depression, liver damage, coronary artery disease, coma, and severe hypotension or hypertension. The use of clozapine is not contraindicated in clients with upper respiratory infection, diabetes insipidus or osteoarthritis.

A client, who has been diagnosed with schizophrenia and is taking an antipsychotic medication, reports constant thirst, frequent urination, and feeling nauseous. The nurse knows that the client may:

have undiagnosed diabetes. Explanation: Schizophrenic clients have a higher than normal incidence of diabetes. The flu usually has a fever along with respiratory symptoms. A urinary tract infection may cause burning and frequent urination, but thirst is not normally a symptom. Also, UTIs are not more common in schizophrenics. A client could be making up symptoms, but the nurse should first consider other options that could be causing the symptoms.

A 10-year-old boy is taking dextroamphetamine (Dexedrine) daily for ADHD. At each clinic visit, the nurse must assess the child. The priority assessment since he is on this medication would be which?

height and weight. Explanation: The nurse should assess blood pressure, body temperature, and vision at each clinic visit as routine nursing measures in caring for a pediatric client. However, the priority assessment would be of height and weight. Monitoring the growth and development of children taking amphetamines is extremely important because these drugs have been associated with growth suppression.

Due to the actions of caffeine, the nurse is concerned when it is consumed by clients with what medical diagnosis? Select all that apply.

hx of stroke bipolar disorder cardiac dysrhythmias

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention?

improving Explanation: CNS stimulants improve behavior and attention in clients with ADHD.

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?

reduced adverse effects